Zena Elizabeth Helen Moore

• PhD, MSc (Leadership in Health Professionals Education), MSc (Wound Healing & Tissue Repair), PG Dip, Dip Management, FFNMRCSI
• Head of Department at Royal College of Surgeons in Ireland

Background Chronic wounds can pose a significant challenge for patients and healthcare professionals including the morbidity and associated costs. It is therefore essential to understand the specific challenges faced by patients to make wound care services more effective and convenient for the patient population. Aim Using the PEO model, this syste...

Background Pressure ulcers occur when people cannot reposition themselves to relieve pressure over bony prominences. They are difficult to heal, costly, and reduce quality of life. Dressings and topical agents (lotions, creams, and oils) for pressure ulcer prevention are widely used. However, their effectiveness is unclear. This is the third update...

Pressure ulcers (PU) are a globally recognised healthcare concern, with their largely preventable development prompting the implementation of targeted preventive strategies. Risk assessment is the first step to planning individualised preventive measures. However, despite the long use of risk assessment, and the >70 risk assessment tools currently...

This commentary considers the similarities which exist between pressure ulcers (PUs) and diabetic foot ulcers (DFUs). It aims to describe what is known to be shared—both in theory and practice—by these wound types. It goes on to detail the literature surrounding the role of inflammation in both wound types. PUs occur following prolonged exposure to...

The aim of this study was to explore psychiatric nurse's experiences of caring for people with auditory hallucinations in an acute unit. A qualitative study was conducted using thematic analysis. The study involved semi‐structured interviews with 18 acute unit nurses all of whom provided interventions to patients with auditory hallucinations. Overa...

To assess all published studies which describe what happens to the delivery of pressure ulcer/injury (PI/PU) care pathways as a result of detecting raised sub‐epidermal moisture (SEM) delta (∆ ≥ 0.6). We undertook a systematic review of the literature, and included original research studies using either a prospective or retrospective study design t...

Transforming Wound Care Education: Enhancing Postgraduate Learning through a hybrid approach based on engagement and reflective learning

Objective To conduct a systematic review to identify the impact of diabetic foot ulceration (DFU) on health-related quality of life (HRQoL) in individuals within the Arab world. Method A PRISMA-guided systematic search for HRQoL studies in Arab populations was conducted in CINAHL, PubMed, Scopus and EBSCO. Relevant studies were critically appraise...

Aim To determine the impact of home‐based management on hospital re‐admission rates in patients with chronic obstructive pulmonary disease (COPD). Design Systematic review methodology was utilized, combining meta‐analysis, where appropriate, or a narrative analysis of the data from included studies. Data Sources Electronic databases CINAHL, MEDLI...

Aim To gain a greater understanding of how compression therapy affects quality of life, this systematic review appraised existing published studies measuring the impact of compression therapy on health quality of life (HRQoL), and pain, among people with venous leg ulcers (VLU). Method Five databases were searched, and two authors extracted data a...

The correlation between sub-epidermal moisture (SEM) and other early indicators of pressure ulcer (PU) development is yet to be determined. This two-part series aims to bridge this knowledge gap, through investigating SEM and its correlation with evidence-based technologies and assessments. This article focuses on the correlation between SEM and ul...

Purpose This systematic review paper aims to investigate seasonal ambient change’s impact on the incidence of falls among older adults. Design/methodology/approach The population, exposure, outcome (PEO) structured framework was used to frame the research question prior to using the Preferred Reporting Items for Systematic Reviews and Meta-Analysi...

DEBRA International is undertaking a long-term initiative to develop clinical practice guidelines (CPGs) for epidermolysis bullosa (EB), to ­improve the clinical care of people living with EB. Current neonatal care is based on evidence, clinical expertise and trial and error, with collaboration between the EB specialist team, parent or carer and pa...

Aim To develop an eHealth resource to support fibromyalgia patients and explore it for usability and impact on their self-management and self-efficacy. Background Fibromyalgia is a complex, non-progressive chronic condition characterised by a bewildering array of symptoms for patients to self-manage. International guidelines recommend patients rec...

Aim: This prospective observational study investigated wound area reduction (WAR) outcomes in a complex wound population composed of non-healing acute and chronic wounds. The relationship between bacterial autofluorescence signals and WAR was investigated. Area measurements were collected both manually and digitally, and both methods were compared...

Background: Stroke is a leading cause of disability and death in adults. Hypertension, diabetes mellitus, hyperlipidaemia and atherosclerosis are reported to be the most common causes for stroke. The World Health Organisation has reported that the most common nutritional deficiency in the world is iron deficiency anaemia [IDA] affecting 30% of the...

A 47-year-old woman who presented to the hospital with left sided weakness, left sided paraesthesia, ataxic gait, headache, nausea and vomiting was found to have multiple infarct strokes. Her past medical history was significant for iron deficiency anaemia secondary to menorrhagia. Her haemoglobin level on arrival at the hospital was 7.3 gm/dl. Her...

Association between iron deficiency anaemia and ischemic stroke with a focus on the incidence, clinical presentation and treatment outcome in Adults: Research protocol

Aim. This systematic review aimed to synthesise the relationship between transformational leadership style and staff nurse retention in hospital settings. Background. It is known that globally there is a shortage of nurses. Thus, nurse retention and organisational commitment have never been more critical. Nurse managers are responsible for staff re...

Objectives The National Pressure Injury Advisory Panel, European Pressure Ulcer Advisory Panel and the Pan Pacific Pressure Injury Alliance are commencing a new (fourth) edition of Prevention and Treatment of Pressure Ulcers/Injuries: Clinical Practice Guideline . The aim is to outline the methodology. Methods The fourth edition of the Internation...

Aims To determine the impact of a multi‐component exercise intervention on the cure rate of urinary incontinence (UI) among older women living in the community. Method A systematic search was conducted of five databases (Medline, Cumulative Index to Nursing and Allied Health Literature [CINAHL], Academic Search Complete, PubMed and Web of Science)...

This poster presents the findings of the recently published consensus guidelines of the same name.

Background Stoma formation is a commonly performed procedure both during and following colorectal surgery. When designed correctly, stomas can dramatically improve patients’ quality of life, but the reverse may occur when complications arise. Given the significant negative impact of complications following stoma formation, understanding risk factor...

Background Traumatic brain injuries (TBIs) are one of the leading causes of death or long‐term disability around the world. As a result of improvements in supportive care, patients are surviving more severe insults with more pronounced dependency on their families, hospitals, and long‐term care facilities. The introduction of brain tissue oxygenati...

Background: Inherited epidermolysis bullosa (EB) is a cluster of rare, genetic skin and mucosal fragility disorders with multi-system and secondary effects, in which blistering and erosions occur in response to friction/mechanical trauma. Considering the incurable and potentially life-limiting nature of the condition and the challenges posed by its...

Objective The aim of this systematic review was to critically appraise and synthesise the existing research literature pertaining to nurses' attitudes toward pressure ulcer (PU) prevention. Method The systematic review presented in our paper serves as an updated version of the definitive review conducted by Avsar et al. in 2019. Using systematic r...

Objective To investigate the impact of education for healthcare assistants (HCAs) on their knowledge and skills in pressure ulcer (PU) prevention and on the incidence of PUs. A secondary aim was to evaluate education methodologies used in PU prevention programmes. Method Using systematic review methodology, key databases were searched with no limi...

Pressure ulcers (PUs) remain a chronic health problem with severe impacts on healthcare systems. Early detection is crucial to providing effective interventions. However, detecting PUs currently relies on subjective tissue evaluations, such as visual skin assessment, precluding interventions prior to the development of visible tissue damage. There...

Aim of the study: To develop and undertake validation testing of a survey designed to measure patients' experiences of and preferences for surgical wound care discharge education. Materials and methods: A literature review and content analysis was undertaken on patients' experiences of and preferences for surgical wound care discharge education....

Aims: The aims of this study were to assess the health-related quality of life (HRQoL) of adult Bahraini patients with diabetic foot ulcers (DFU) and to explore factors associated with poor HRQoL. Methods: Cross-sectional HRQoL data were obtained from a sample of patients in active treatment for DFU at a large public hospital in Bahrain. Patient...

Aim: To determine the monetary costs identified in economic evaluations of treatment with compression bandages among adults with venous leg ulcers (VLU). Method: A scoping review of existing publications was conducted in February 2023. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used. Results:...

Chronic venous disease (CVD) occurs because of structural or functional disturbances to the venous system of the lower limbs. Signs and symptoms include leg pain, swelling, varicose veins, and skin changes, with venous ulceration ultimately occurring in severe disease. To assess the prevalence of CVD among health care workers, a scoping review of e...

Objective The aim of this study was to measure wound pH, wound temperature and wound size together to gain further understanding of their impact as predictors of wound healing outcomes. Method This study employed a quantitative non-comparative, prospective, descriptive observational design. Participants with both acute and hard-to-heal (chronic) w...

Hard-to-heal wounds are a common side-effect of diabetes, obesity, pressure ulcers and age-related vascular diseases, the incidences of which are growing worldwide. The increasing financial burden of hard-to-heal wounds on global health services has provoked technological research into improving wound diagnostics and therapeutics via 'smart' dressi...

Aims: To assess patients' and nurses' perceptions and experiences of subepidermal moisture scanning acceptability. Design: Descriptive, qualitative, sub-study, embedded within a pilot randomized control trial. Methods: Ten patients who were in the intervention arm of the pilot trial and 10 registered nurses providing care for these patients on...

Purpose: To explore the effect of silicone dressings on the prevention of pressure injuries in patients cared for in the acute care setting. Three main comparisons were explored: silicone dressing versus no dressing, all anatomical areas; silicone dressing versus no dressing on the sacrum; and silicone dressing versus no dressing on the heels. Me...

Background Sarcopenia is a multifactorial loss of muscle mass that can complicate surgical outcomes and increase morbidity and mortality. Parastomal hernias can occur after any surgery requiring stoma formation and is an area of concern as a complication as it can require a second surgery or emergency surgical intervention. Aim To assess the impac...

Objective Pressure ulcers (PUs) commonly occur over bony prominences and are notoriously difficult to treat. Proinflammatory cytokines are substances that initiate the inflammatory process preceding PU development. The aim of this review was to assess whether the increased presence of proinflammatory cytokines could potentially be used as an early...

Background Intracranial pressure (ICP) monitoring and cerebral perfusion pressure (CPP) monitoring are long established adjuncts in the management of traumatic brain injuries (TBIs). However, brain tissue oxygenation (PbtO 2 ) monitoring, used in conjunction with ICP or CPP monitoring, is an additional element that could be used in directing the ma...

This study aimed to investigate the impact of sub epidermal moisture (SEM) measurement and targeted pressure ulcer (PU) prevention, versus visual skin assessment and usual care, on mean SEM delta scores and early pressure ulcer development in acute hospital patients. A quantitative quasi‐experimental observational approach was used. A total of 149...

Objectives To ascertain the impact of home non-invasive ventilation (NIV) on the health-related quality of life (HRQL) of patients with moderate-to-severe chronic obstructive pulmonary disease (COPD). Design Systematic review. Methods A preliminary search of computerised databases (CINAHL, Medline, Clinical Key, Cochrane) was conducted in June 20...

Objective After launching the 2019 International Pressure Ulcer/Injury Guideline, the National Pressure Injury Advisory Panel (NPIAP), the European Pressure Ulcer Advisory Panel (EPUAP) and the Pan Pacific Pressure Injury Alliance (PPPIA) collaborated with Sensorydata Corp., US, to develop a guideline app (InterPIP App). The app was designed to: pr...

The aim of this feasibility study was to investigate the impact of inflammation management on wound pH, temperature, and bacterial burden, using the principles of TIME and Wound Bed Preparation. A quantitative non-comparative, prospective, descriptive observational design. Following ethical approval, 26 participants with 27 wounds of varying aetiol...

Background: Prone positioning has been widely used to improve oxygenation and reduce ventilator-induced lung injury in patients with severe COVID-19 acute respiratory distress syndrome (ARDS). One major complication associated with prone positioning is the development of pressure ulcers (PUs). Aim: This study aimed to determine the impact of a p...

Objective The aim of this clinically orientated paper is to offer an overview of diabetic foot ulcer (DFU) dressings generally, and more specifically, their use in the treatment of DFUs. Method The TIME clinical decision support tool (CDST) has been used as a clinical tool that can help clinicians bring together the different aspects of dressings...

Pressure ulcer (PU) prevention in the intensive care unit (ICU) is an important clinical issue as critically unwell patients are at high risk of developing PUs. However, current methods of PU detection are limited, especially for early detection. This study aimed to establish the correlation between Interleukin‐1α (IL‐1α)/total protein (TP) and sub...

This systematic review aimed to examine skin hydration and determine if this biophysical parameter can predict pressure ulcer development in at risk adults. A literature search was conducted in March 2022, using PubMed, CINAHL, SCOPUS, Cochrane, and EMBASE databases. A total of 1727 records were returned, with 9 studies satisfying the inclusion cri...

Objective To determine the impact of lower limb lymphoedema (LLL) on health-related quality of life (HRQoL), and to identify the methodologies used to assess HRQoL and their adherence to the World Health Organization (WHO)-recommended HRQoL dimensions. Method A systematic review was used following the PRISMA guidance. Studies were eligible if they...

Objective The aim was to assess evidence related to the measuring of subepidermal moisture (SEM) to detect early, nonvisible development of pressure ulcers (PUs). Method Using systematic review methodology, all quantitative animal and human research studies written in English were considered. In January 2021, PubMed, CINAHL, SCOPUS, Cochrane and E...

The present study sought to explore the impact of movement monitoring devices on risk prediction and prevention of pressure ulcers (PU) among adults. Using systematic review methodology, we included original research studies using a prospective design, written in English, assessing adult patients' movement in bed, using a movement monitoring device...

This meta-review aimed to appraise and synthesise findings from existing systematic reviews that measured the impact of compression therapy on venous leg ulcers healing. We searched five databases to identify potential papers; three authors extracted data, and a fourth author adjudicated the findings. The AMSTAR-2 tool was used for quality appraisa...

Wounds continue to be of a global concern. Therefore, a more focussed, evidence‐based approach to wound assessment and management is required. The WOUND COMPASS™ Clinical Support App (CSA) is designed to support the health care professional with wound assessment and management at the point of care. This real‐world pilot study aimed to determine the...

Objective: This systematic review assesses the effects of care bundles on the incidence of surgical site infections (SSIs). Data sources: The search was conducted between February and May 2021, using PubMed, CINAHL, SCOPUS, Cochrane, and EMBASE databases. Study selection: Studies were included if they used systematic review methodology, were i...

Early transition to full enteral intake reduces the risk of nosocomial infection and metabolic complications related to prolonged use of parenteral nutrition. Evidence on what feed advancement rates will reduce these complications and minimize extrauterine growth restriction is necessary. This is a systematic review to determine the efficacy and sa...

Aim Sub-epidermal moisture scanning (SEMS) is a novel point-of-care technology that measures localised oedema and detects early tissue damage that may develop into a pressure injury (PI). It provides objective data that may assist PI prevention (PIP) decision making. This study aimed to determine the feasibility of undertaking a definitive randomis...

Purpose Educating patients to self-manage chronic diseases such as asthma is a key role for nurses. The success of this education is often limited by low patient self-efficacy. In this study, we hypothesized that the self-efficacy of patients could be enhanced if their education was based on biofeedback of their own self-management, following a nur...

Background: EM has been hypothesized to help prevent the development of ICU acquired weakness and may therefore result in positive outcomes for ICU patients. Aim: To establish the impact of Early mobilization (EM) on adult Intensive Care Unit (ICU) patients in terms of ICU length of stay (LOS), as well as hospital LOS, duration of mechanical ven...

Aim The aim of this systematic review was to determine the impact that specialist community palliative care teams (SCPCT) have on acute hospital admission rates in adult palliative care (PC) patients who require End of Life Care (EOLC). Method Using systematic review methodology, eight studies were obtained from thorough searching of CINAHL, Medli...

Aim: To examine the impact that patient violence, experienced in the Emergency Department has on emergency nurses' intention to leave their job. Background: Emergency Departments have become known for their overcrowding, chaos, unpredictability, and violence. Emergency nurses are at high risk of experiencing workplace violence which is cited in...

PATTON, D., WILSON, H., AVSAR, P. & MOORE, Z. 2022.Pressure Ulcer Risk and Surgery: Practice Considerations. Wound Masterclass, 1 (1): 70-72. (Editorial) Link to the full-text article: https://issuu.com/woundmasterclass/docs/pressure_ulcer_risk_and_surgery_-_practice_conside?fr=sNDYxMzU1NzEyOTk

Accessible Summary What is known on the subject? There is no qualitative systematic review of nurses' perceptions of their interactions with people hearing voices. There are some studies exploring the interventions provided by community psychiatric nurses to people hearing voices; these give a sense of what interactions may contain. What the pape...

Background Subarachnoid haemorrhage is a form of stroke, classified as traumatic or aneurysmal in origin. Subarachnoid haemorrhage from aneurysmal rupture can cause significant side effects—most frequently, cerebral vasospasm, which increases the risk of developing delayed cerebral ischaemia. Medical and endovascular interventions differ between in...

Objective To compare the predictive ability of subepidermal moisture (SEM) measurement versus traditional risk assessment and visual skin assessment (VSA) as means of detecting early pressure ulcer (PU) damage development among adults undergoing surgery. Method A non-experimental, comparative, descriptive cohort study design was used. Following et...

p>Although great strides have been made to tackle hospital-acquired pressure ulcers (HAPUs), there is a need for greater recognition of device-related pressure ulcers (DRPUs), including their causes, management and prevention. This consensus statement, an updated second edition, aims to continue raising awareness of these largely preventable injuri...

Objective The primary objective of this systematic review was to determine the effect of vasopressor agents on the development of pressure ulcers (PUs) among critically ill patients in intensive care units (ICUs). The secondary outcome of interest was length of stay in the ICU. Method A systematic review was undertaken using the databases searched...

The aim of this study was to determine the impact of a specially designed care bundle on the development of facial pressure injuries among frontline health care workers wearing personal protective equipment (PPE) during the COVID‐19 pandemic. This was a mixed methods study. First, a pre‐posttest observational design was employed to evaluate the imp...

Aim: This review explores the impact of skincare bundles on the development of skin tears in older adults (≥65 years). Method: A systematic search of publications using MEDLINE, CINAHL and Cochrane databases was conducted in July 2020. The evidence-based librarianship (EBL) checklist assessed the methodological quality of the included studies. D...

Objectives The aim of this systematic review (SR) is to establish if video is a beneficial teaching method when teaching psychomotor skills in nursing. Design Systematic review. Data sources A database search of CINAHL, MEDLINE, EMBASE and Cochrane was performed with search terms ‘video’, ‘nurse’ ‘RCT’ and ‘practical skills’ resulting in seventy-...

Objective The use of combined ultrasound and electrostimulation (CUSECS) as an adjunct therapy for diabetic foot ulcers (DFUs) is a relatively new concept. This study aimed to investigate if combined ultrasound and electrostimulation is an effective adjunctive treatment for hard-to-heal DFUs when compared with standard wound care. Methods A random...

To assess the impact of topical agents and dressings on surface wound pH, temperature, and subsequent wound healing. This was a systematic, narrative review of the literature, following the PRISMA (2020) guidelines. The databases searched were Medline PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, Embas...

IntroductionIn orthopaedic surgery, hip fracture patients represent one of the largest cohorts. Hip fracture is a serious injury commonly occurring in frail and elderly patients. Fast-track admission pathways aim to streamline patients through accident and emergency departments, resulting in shorter wait times and less negative patient outcomes.Aim...

Objective Numerous systematic reviews have examined the impact of prone positioning on outcomes, including pressure injury (PI). The objective of this meta-review was to synthesise the evidence on the effect of prone positioning on the incidence and location of PIs in adult intensive care unit patients. Review method This is a meta-review of publi...

Objective To test the feasibility of using a standardised data collection tool to estimate the cost of stage 2–4 pressure ulcer (PU) care within an acute care setting. Method Data on resource use and cost were obtained through a retrospective survey of nursing and medical notes collecting cost data for individual patients who received care for sta...

Background: A pressure ulcer (PU) is a localized injury to the skin or underlying tissue usually over a bony prominence. The prevention PU per patient per day is costly; therefore, the detection of a PU at its earliest stage is imperative to afford timely interventions. Currently, there are very few clinically useful tools to assist with early PU...

PURPOSE: The purpose of this evidence search was to review past and current kangaroo care practice and explore the Iiterature relating to improving kangaroo care for preterm infants. METHOD: A literature review of evidence was undertaken in order to answer pre specified questions. The literature search was undertaken on CINAHL, Google Scholar and P...

Objective The aim of this systematic review was to determine the impact of topical oxygen therapy (TOT) on diabetic foot ulcer (DFU) healing. Method Using systematic review methodology, we considered randomised controlled trials (RCTs), controlled trials, pilot studies and observational studies. The search was conducted in January 2019, using PubM...